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Sanctions target 'rip-off' NHS temps Sanctions target 'rip-off' NHS temps
(about 4 hours later)
The government has announced measures to clamp down on "rip-off" staffing agencies used by the NHS to plug gaps in nursing and doctor rotas.The government has announced measures to clamp down on "rip-off" staffing agencies used by the NHS to plug gaps in nursing and doctor rotas.
It will set a maximum hourly rate for temps and cap the amount trusts that are struggling financially can spend.It will set a maximum hourly rate for temps and cap the amount trusts that are struggling financially can spend.
The agencies' body says they are being scapegoated "for the NHS's own mismanagement of workforce planning".The agencies' body says they are being scapegoated "for the NHS's own mismanagement of workforce planning".
The NHS in England spent nearly £2bn last year on agency and contract staff - more than twice the planned amount. NHS foundation trusts in England spent nearly £2bn last year on agency staff - more than twice the planned amount.
Mr Hunt said the cost of agency and contract staff across the entire NHS in England last year was £3.3bn.
'Expensive consultants''Expensive consultants'
Health Secretary Jeremy Hunt said staff costs had spiralled out of control.Health Secretary Jeremy Hunt said staff costs had spiralled out of control.
On one occasion, an agency nurse cost the NHS £2,200 for a 12-hour shift, and a doctor £3,700 for a 30-hour shift.On one occasion, an agency nurse cost the NHS £2,200 for a 12-hour shift, and a doctor £3,700 for a 30-hour shift.
In some instances, more than half of the money went to the agency itself.In some instances, more than half of the money went to the agency itself.
And hospitals are increasingly hiring expensive management consultants, which cost the NHS nearly £600m last year.And hospitals are increasingly hiring expensive management consultants, which cost the NHS nearly £600m last year.
Cap pricesCap prices
The measures will be phased in over the next few months and include a cap of £50,000 applied to all management-consultancy contracts.The measures will be phased in over the next few months and include a cap of £50,000 applied to all management-consultancy contracts.
Any trust needing to exceed this for clinical reasons will have to get permission from the regulator, Monitor, or the Trust Development Authority.Any trust needing to exceed this for clinical reasons will have to get permission from the regulator, Monitor, or the Trust Development Authority.
Currently, many NHS trusts manage their agency spend through framework agreements that cap prices.Currently, many NHS trusts manage their agency spend through framework agreements that cap prices.
Rates are negotiated by central government, and recruitment agencies should adhere to them.Rates are negotiated by central government, and recruitment agencies should adhere to them.
Bargaining powerBargaining power
But under the new measures, agencies charging above the odds will be barred from use.But under the new measures, agencies charging above the odds will be barred from use.
Mr Hunt said: "Expensive staffing agencies are quite simply ripping off the NHS.Mr Hunt said: "Expensive staffing agencies are quite simply ripping off the NHS.
"It's outrageous that taxpayers are being taken for a ride by companies charging up to £3,500 a shift for a doctor."It's outrageous that taxpayers are being taken for a ride by companies charging up to £3,500 a shift for a doctor.
"The NHS is bigger than all of these companies, so we'll use that bargaining power to drive down rates and beat them at their own game.""The NHS is bigger than all of these companies, so we'll use that bargaining power to drive down rates and beat them at their own game."
Simon Stevens, chief executive of NHS England, has said the rising costs are partly due to hospitals putting more nurses on wards, following the public inquiry into the Stafford Hospital scandal.Simon Stevens, chief executive of NHS England, has said the rising costs are partly due to hospitals putting more nurses on wards, following the public inquiry into the Stafford Hospital scandal.
Others blame government mismanagement of the NHS.Others blame government mismanagement of the NHS.
AnalysisAnalysis
Agency staff will always have a role in the NHS.Agency staff will always have a role in the NHS.
The government's beef is not about using temps to cover busy periods or staff sickness.The government's beef is not about using temps to cover busy periods or staff sickness.
It is about an over-reliance by the NHS in England on expensive locums that line the pockets of what Mr Hunt calls "rip-off" agencies.It is about an over-reliance by the NHS in England on expensive locums that line the pockets of what Mr Hunt calls "rip-off" agencies.
So why is this happening, and who's to blame?So why is this happening, and who's to blame?
Many agency nurses have had long careers as NHS employees but have left - because of the pay and the hours, for example.Many agency nurses have had long careers as NHS employees but have left - because of the pay and the hours, for example.
Some shifts, such as working in A&E, are particularly hard to fill.Some shifts, such as working in A&E, are particularly hard to fill.
When the work is brutal, or the hospital is unpopular, it can be hard to find permanent staff to take up posts.When the work is brutal, or the hospital is unpopular, it can be hard to find permanent staff to take up posts.
Jobs abroad may be far more attractive for NHS employees and new graduates.Jobs abroad may be far more attractive for NHS employees and new graduates.
The industry body that oversees recruitment agencies says the root problem is poor workforce planning, which has left the NHS short of nurses.The industry body that oversees recruitment agencies says the root problem is poor workforce planning, which has left the NHS short of nurses.
The Royal College of Nursing agrees. It says too many nursing posts have been cut and too few student nurses are coming up the ranks to fill the void.The Royal College of Nursing agrees. It says too many nursing posts have been cut and too few student nurses are coming up the ranks to fill the void.
Arguably, without agency staff pitching in, the NHS and its patients would suffer.Arguably, without agency staff pitching in, the NHS and its patients would suffer.
Recruitment and Employment Confederation director of policy Tom Hadley told BBC News: "The language and tone from Jeremy Hunt is outrageous.Recruitment and Employment Confederation director of policy Tom Hadley told BBC News: "The language and tone from Jeremy Hunt is outrageous.
"Agency nurses play a vital role in ensuring safe staffing ratios and quality patient care in an NHS that cannot find sufficient permanent staff."Agency nurses play a vital role in ensuring safe staffing ratios and quality patient care in an NHS that cannot find sufficient permanent staff.
"Nobody objects to there being set parameters for pricing of agency staff, but they already exist in the form of NHS framework agreements."Nobody objects to there being set parameters for pricing of agency staff, but they already exist in the form of NHS framework agreements.
"We just don't see how it is feasible to bring in new rules at this short notice."We just don't see how it is feasible to bring in new rules at this short notice.
"We are disappointed that the Department of Health has not consulted around the introduction of these new rules and await more detail about exactly how they propose to reconcile them with NHS trusts' legal responsibility to ensure safe staffing levels on wards."We are disappointed that the Department of Health has not consulted around the introduction of these new rules and await more detail about exactly how they propose to reconcile them with NHS trusts' legal responsibility to ensure safe staffing levels on wards.
"What happens, for instance, if there is a cold snap and a trust needs staff instantly to manage an influx of demand but they have already reached their newly imposed cap on overall spend?""What happens, for instance, if there is a cold snap and a trust needs staff instantly to manage an influx of demand but they have already reached their newly imposed cap on overall spend?"
'Monumental waste''Monumental waste'
Andy Burnham MP, Labour's shadow health secretary, said: "The decision to cut 6,000 nursing posts in the early years of the last Parliament, alongside big reductions in nurse training places, has left the NHS in the grip of private staffing agencies.Andy Burnham MP, Labour's shadow health secretary, said: "The decision to cut 6,000 nursing posts in the early years of the last Parliament, alongside big reductions in nurse training places, has left the NHS in the grip of private staffing agencies.
"The Tory government is responsible for this monumental waste of NHS resources.""The Tory government is responsible for this monumental waste of NHS resources."
The British Medical Association said the overspend on management consultants had been to help hospitals navigate the government-driven reorganisation of the NHS.The British Medical Association said the overspend on management consultants had been to help hospitals navigate the government-driven reorganisation of the NHS.
Dr Peter Carter, head of the Royal College of Nursing, said while it was right to clamp down on excessive spending, "this will only work alongside longer term solutions, like converting agency staff to permanent staff, and continuing to increase training places to catch up with demand".Dr Peter Carter, head of the Royal College of Nursing, said while it was right to clamp down on excessive spending, "this will only work alongside longer term solutions, like converting agency staff to permanent staff, and continuing to increase training places to catch up with demand".
'Strong message''Strong message'
Claire Billieness, managing director of an agency called HCL workforce solutions, which supplies the NHS with temporary staff, hoped the move would help create a level playing field for agencies.Claire Billieness, managing director of an agency called HCL workforce solutions, which supplies the NHS with temporary staff, hoped the move would help create a level playing field for agencies.
"Approved framework rates do already exist," she said."Approved framework rates do already exist," she said.
"However, it is the enforcements of these rates that has been a problem in the past."However, it is the enforcements of these rates that has been a problem in the past.
"It will also send a very strong message to career locums that holding out for the best price is no longer an option.""It will also send a very strong message to career locums that holding out for the best price is no longer an option."
Danny Mortimer, of NHS Employers, said: "We welcome this focus on the agency market. Clearly, we await further detail."Danny Mortimer, of NHS Employers, said: "We welcome this focus on the agency market. Clearly, we await further detail."